Stability and manipulation in representative democracies

This paper is devoted to the analysis of all constitutions equipped with electoral systems involving two step procedures. First, one candidate is elected in every jurisdiction by the electors in that jurisdiction, according to some aggregation procedure. Second, another aggregation procedure collects the names of the jurisdictional winners in order to designate the final winner. It appears that whenever individuals are allowed to change jurisdiction when casting their ballot, they are able to manipulate the result of the election except in very few cases. When imposing a paretian condition on every jurisdictions voting rule, it is shown that, in the case of any finite number of candidates, any two steps voting rule that is not manipulable by movement of the electors necessarily gives to every voter the power of overruling the unanimity on its own. A characterization of the set of these rules is next provided in the case of two candidates.

Addressing Sea Surface Salinity retrieval at different spatial resolution. Feasibility study using OCCAM data within SEPS simulator and L2 processor tools

Projecte de recerca elaborat a partir d’una estada a la National Oceanography Centre of Southampton (NOCS), Gran Bretanya, entre maig i juliol del 2006. La possibilitat d’obtenir una estimació precissa de la salinitat marina (SSS) és important per a investigar i predir l’extensió del fenòmen del canvi climàtic. La missió Soil Moisture and Ocean Salinity (SMOS) va ser seleccionada per l’Agència Espacial Europea (ESA) per a obtenir mapes de salinitat de la superfície marina a escala global i amb un temps de revisita petit. Abans del llençament de SMOS es preveu l’anàlisi de la variabilitat horitzontal de la SSS i del potencial de les dades recuperades a partir de mesures de SMOS per a reproduir comportaments oceanogràfics coneguts. L’objectiu de tot plegat és emplenar el buit existent entre les fonts de dades d’entrada/auxiliars fiables i les eines desenvolupades per a simular i processar les dades adquirides segons la configuració de SMOS. El SMOS End-to-end Performance Simulator (SEPS) és un simulador adhoc desenvolupat per la Universitat Politècnica de Catalunya (UPC) per a generar dades segons la configuració de SMOS. Es va utilitzar dades d’entrada a SEPS procedents del projecte Ocean Circulation and Climate Advanced Modeling (OCCAM), utilitzat al NOCS, a diferents resolucions espacials. Modificant SEPS per a poder fer servir com a entrada les dades OCCAM es van obtenir dades de temperatura de brillantor simulades durant un mes amb diferents observacions ascendents que cobrien la zona seleccionada. Les tasques realitzades durant l’estada a NOCS tenien la finalitat de proporcionar una tècnica fiable per a realitzar la calibració externa i per tant cancel•lar el bias, una metodologia per a promitjar temporalment les diferents adquisicions durant les observacions ascendents, i determinar la millor configuració de la funció de cost abans d’explotar i investigar les posibiltats de les dades SEPS/OCCAM per a derivar la SSS recuperada amb patrons d’alta resolució.

Implicit attitudes and self-concepts towards transgression and aggression: Differences between male community and offender adolescents, and associations with psychopathic traits.

Research suggests that implicit attitudes play a key role in the occurrence of antisocial behaviours. This study assessed implicit attitudes and self-concepts related to aggression and transgression in community and offender adolescents, using a new set of Implicit Association Tests (IATs), and examined their association with of psychopathic traits. Thirty-six offenders and 66 community adolescents performed 4 IATs assessing 1) implicit attitudes about a) aggression and b) transgression as good, and 2) implicit self-concepts about a) aggression and b) transgression as self-descriptive. They filled in self-report questionnaires: the Youth Psychopathic Traits Inventory, the Child Behaviour Checklist, and explicit measures of their attitudes and self-concepts towards transgression and aggression. Results showed few differences between community and offender adolescents on implicit attitudes and self-concepts, and unexpected negative associations between some implicit attitudes and psychopathic traits, while the association was positive for the corresponding explicit attitudes. Possible explanations of these findings are discussed.

Development of mavoglurant and its potential for the treatment of fragile X syndrome.

Introduction: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability. With no curative treatment available, current therapeutic approaches are aimed at symptom management. FXS is caused by silencing the FMR1 gene, which encodes FMRP; as loss of FMRP leads to the development of symptoms associated with FXS. Areas covered: In this evaluation, the authors examine the role of the metabotropic glutamate receptor 5 (mGluR5) in the pathophysiology of FXS, and its suitability as a target for rescuing the disease state. Furthermore, the authors review the evidence from preclinical studies of pharmacological interventions targeting mGluR5 in FXS. Lastly, the authors assess the findings from clinical studies in FXS, in particular the use of the Aberrant Behavior Checklist-Community Edition (ABC-C) and the recently developed ABC-C for FXS scale, as clinical endpoints to assess disease modification in this patient population. Expert opinion: There is cautious optimism for the successful treatment of the core behavioral and cognitive symptoms of FXS based on preclinical data in animal models and early studies in humans. However, the association between mGluR5-heightened responsiveness and the clinical phenotype in humans remains to be demonstrated. Many questions regarding the optimal treatment and outcome measures of FXS remain unanswered.

Post operative epidural haematomas following spinal surgery : P58

Introduction: Compressive epidural haematomas occurring following spine surgery are very rare but can potentially lead to irreversible damage. The evacuation of the haematoma as an emergency procedure remains the only effective treatment providing though alerting signs are detected on time. Few studies exist on this subject probably due to its rarity. The etiological factors as well as the place of imaging studies prior to urgent haematoma evacuation remain controversial. Two cases of delayed post-operative compressive epidural haematomas following lumbar-spine surgery were detected in our unit between April 2003 and January 2009. In both cases new onset of pain, aggravation of existing neurological deficit or development of new deficit along with worsening of pre-existing walking difficulties were noted. Emergency computer tomography (CT) could not exclude compression in both cases due to important artefacts. Emergency surgery was performed confirming the presence of haematoma in both cases and leading to a complete neurological recovery following its evacuation. As only risk factors common to both cases we identified drain removal and resuming of thromboprophylaxis. Conclusion: Obstacles in early detection of post-operative compressive epidural haematomas occurring following spine surgery are patients presenting with multiple complaints as well as shift work pattern of staff who might not always be trained in detecting early changes in neurological status. We therefore established a checklist for post-operative neurological observations to be carried out on spine surgery patients during the postoperative period. We describe our adopted attitude considering the etiological factors observed in our unit. Further studies including in a multi centre setting would be necessary in order to ascertain our observations.

Three-year-olds' attachment play narratives and their associations with internalizing problems

Representational strategies of emotion regulation during play are believed to protect children against behaviour problems. Yet, before the age of 4, it appears that children rely more on their attachment figure than on representational strategies to assuage distress. The study was aimed at testing whether 3-year-olds' narrative features during the Attachment Story Completion Task (ASCT) could predict concurrent internalizing problems assessed by the mothers' and fathers' ratings of the child, using the Child Behaviour Checklist Regression analyses including gender, IQ, socio-economic status and ASCT dimensions revealed that representations of supportive caregiving predicted mother-reported internalizing problems (negative association), whereas positive resolution and attachment strategies (security, deactivation, hyperactivation, disorganization) did not. Results were interpreted with reference to Bowlby's hypotheses regarding the aetiology of depression and anxiety disorders. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Development and Consequences of Referendum Campaigns in Switzerland, 1981-1999

Since the early 1990s, new forms of referendum campaigns have emerged in the Swiss political arena. In this paper, we examine how referendum campaigns have transformed in Switzerland, focusing on a number of features: their intensity, duration and inclusiveness (i.e., the variety of actors involved). These features are assumed to change in the long run in response to societal changes and in the short run as a function of variations in elite support. We further argue that public knowledge of ballot issues depends on the characteristics of campaigns. To formally test our hypotheses, we draw on advertisement campaigns in six major Swiss newspapers in the four weeks preceding each ballot from 1981 to 1999 and develop a structural equation model. We indeed find that the duration of referendum campaigns has increased over time, while their inclusiveness has decreased. Most importantly, we find that pub­lic knowledge is strongly related to the characteristics of campaigns

Individual versus standard quality of life assessment in a phase II clinical trial in mesothelioma patients: feasibility and responsiveness to clinical changes.

BACKGROUND: In patients with malignant pleural mesothelioma undergoing a multimodality therapy, treatment toxicity may outweigh the benefit of progression-free survival. The subjective experience across different treatment phases is an important clinical outcome. This study compares a standard with an individual quality of life (QoL) measure used in a multi-center phase II trial. PATIENTS AND METHODS: Sixty-one patients with stage I-III technically operable pleural mesothelioma were treated with preoperative chemotherapy, followed by pleuropneumonectomy and subsequent radiotherapy. QoL was assessed at baseline, at day 1 of cycle 3, and 1, 3 and 6 months post-surgery by using the Rotterdam Symptom Checklist (RSCL) and the Schedule for the Evaluation of Quality of Life-Direct Weighting (SEIQoL-DW), a measure that is based on five individually nominated and weighted QoL-domains. RESULTS: Completion rates were 98% (RSCL) and 92% (SEIQoL) at baseline and 98%/89% at cycle 3, respectively. Of the operated patients (N=45) RSCL and SEIQoL were available from 86%/72%, 93%/74%, and 94%/76% at months 1, 3, and 6 post-surgery. Average assessment time for the SEIQoL was 24min compared to 8min needed for the RSCL. Median changes from baseline indicate that both RSCL QoL overall score and SEIQoL index remained stable during chemotherapy with a clinically significant deterioration (change>or=8 points) 1 month after surgery (median change of -66 and -14 for RSCL and SEIQoL, respectively). RSCL QoL overall scores improved thereafter, but remained beneath baseline level until 6 months after surgery. SEIQoL scores improved to baseline-level at month 3 after surgery, but worsened again at month 6. RSCL QoL overall score and SEIQoL index were moderately correlated at baseline (r=.30; p<or=.05) and at 6-month follow-up (r=.42; p<or=.05) but not at the other time points. CONCLUSION: The SEIQoL assessment seems to be feasible within a phase II clinical trial, but may require more effort from staff. More distinctive QoL changes in accordance with clinical changes were measured with the RSCL. Our findings suggest that the two measures are not interchangeable: the RSCL is to favor when mainly information related to the course of disease- and treatment is of interest.

Speech by Mr Micheál Martin TD at Launch of Pre-Registration Nursing Degree Programme

Good afternoon ladies and gentlemen. I am very pleased that you were all able to accept my invitation to join me here today on this landmark occasion for nursing education. It is fitting that all of the key stakeholders from the health and education sectors should be so well represented at the launch of an historic new development. Rapid and unpredictable change throughout society has been the hallmark of the twenty-first century, and healthcare is no exception. Regardless of what change occurs, no one doubts that nursing is intrinsic to the health of this nation. However, significant changes in nurse education are now needed if the profession is to deliver on its social mandate to promote people´s health by providing excellent and sensitive care. As science, technology and the demands of the public for sophisticated and responsive health care become increasingly complex, it is essential that the foundation of nursing education is redesigned. Pre-registration nursing education has already undergone radical change over the past eight years, during which time it has moved from an apprenticeship model of education and training to a diploma based programme firmly rooted in higher education. The Secretary General of my Department, Michael Kelly, played a leading role in bringing about this transformation, which has greatly enhanced the way students are prepared for entry to the nursing profession. The benefits of the revised model of education are clearly evident from the quality of the nurses graduating from the diploma programme. The Commission on Nursing examined the whole area of nursing education, and set out a very convincing case for educating nursing students to degree level. It argued that nurses of the future would be required to possess increased flexibility and the ability to work autonomously. A degree programme would provide nurses with a theoretical underpinning that would enable them to develop their clinical skills to a greater extent and to respond to future challenges in health care, for the benefit of patients and clients of the health services. The Commission has provided a solid framework for the professional development of nurses and midwives, including a process that is already underway for the creation of clinical nurse specialist and advanced nurse practitioner posts. This process will facilitate the transfer of skills across divisions of nursing. In this scenario, it is clearly desirable that the future benchmark qualification for registration as a nurse should be a degree in nursing studies. A Nursing Education Forum was established in early 1999 to prepare a strategic framework for the implementation of a nursing degree programme. When launching the Forum´s report last January, I indicated that the Government had agreed in principle to the introduction of the proposed degree programme next year. At the time two substantial outstanding issues had yet to be resolved, namely the basis on which nurse teachers would transfer from the health sector to the education sector and the amount of capital and revenue funding required to operate the degree programme. My Department has brokered agreements between the Nursing Alliance and the Higher Education Institutions for the assimilation of nurse teachers as lecturers into their affiliated institutions. The terms of these agreements have been accepted by all four nursing unions following a ballot of their nurse teacher members. I would like to pay particular tribute to all nurse teachers who have contributed to shaping the position, relevance and visibility of nursing through leadership, which embodies scholarship and excellence in the profession of nursing itself. In response to a recommendation of the Nursing Education Forum, I established an Inter-Departmental Steering Committee, chaired by Bernard Carey of my Department, to consider all the funding and policy issues. This Steering Committee includes representatives of the Department of Finance and the Department of Education and Science as well as the Higher Education Authority. The Steering Committee has been engaged in intensive negotiations with representatives of the Conference of Heads of Irish Universities and the Institutes of Technology in relation to their capital and revenue funding requirements. These negotiations were successfully concluded within the past few weeks. The satisfactory resolution of the industrial relations and funding issues cleared the way for me to go to the Government with concrete proposals for the implementation of degree level education for nursing students. I am delighted to announce here today that the Government has approved all of my proposals, and that a four-year undergraduate pre-registration nursing degree programme will be implemented on a nation-wide basis at the start of the next academic year, 2002/2003. The Government has approved the provision of capital funding totalling £176 million pounds for a major building and equipment programme to facilitate the full integration of nursing students into the higher education sector. This programme is due to be completed by September 2004, and will ensure that nursing students are accommodated in purpose built schools of nursing studies with state of the art clinical skills and human science laboratories at thirteen higher education sites throughout the country. The Government has also agreed to make available the substantial additional revenue funding required to support the nursing degree programme. By 2006, the full year cost of operating the programme will rise to some £43 million pounds. The scale of this investment in pre-registration nursing education is enormous by any yardstick. It demonstrates the firm commitment of myself and my Government colleagues to the full implementation of the recommendations of the Commission on Nursing, of which the introduction of pre-registration degree level education is arguably the most important. This historic decision, and it is truly historic, will finally put the education of nurses on a par with the education of other health care professionals. The nursing profession has long been striving for parity, and my own involvement in the achievement of it is a matter of deep personal satisfaction to me. I am also pleased to announce that the Government has approved my plans for increasing the number of nursing training places to coincide with the implementation of the degree programme next year. Ninety-three additional places in mental handicap and psychiatric nursing will be created at Athlone, Letterkenny, Tralee and Waterford Institutes of Technology. This will yield 392 extra places over the four years of the degree programme. A total of 1,640 places annually on the new degree programme will thus be available. This is an all-time record, and maintaining the annual student intake at this level for the foreseeable future is a key element of my overall strategy for ensuring that we produce sufficient “home-grown” nurses for our health services. I am aware that the Nursing Alliance were anxious that some funding would be provided for the further academic career development of nurse teachers who transfer to one of the six Universities that will be involved in the delivery of the degree programme. I am happy to confirm that up to £300,000 in total per year will be available for this purpose over the first four years of the degree programme. In line with a recommendation of the Commission on Nursing, my Department will have responsibility for the administration of the nursing degree budget until the programme has been bedded down in the higher education sector. A primary concern will be to ensure that the substantial capital and revenue funding involved is ring-fenced for nursing studies. It is intended that responsibility for the budget will be transferred to the Department of Education and Science after the first cohort of nursing degree students have graduated in 2006. In the context of today´s launch, it is relevant to refer to a special initiative that I introduced last year to assist registered nurses wishing to undertake part-time nursing degree courses. Under this initiative, nurses are entitled to have their course fees paid by their employers in return for a commitment to continue working in the public health service for a period following completion of the course. This initiative has proved extremely popular with large numbers of nurses availing of it. I want to confirm here today that the free fees initiative will continue in operation until 2005, at a total cost of at least £15 million pounds. I am giving this commitment in order to assure this year´s intake of nursing students to the final diploma programmes that fee support for a part-time nursing degree course will be available to them when they graduate in three years time. The focus of today´s celebration is rightly on the landmark Government decision to implement the nursing degree programme next year. As Minister for Health and Children, and as a former Minister for Education, I also have a particular interest in the educational opportunities available to other health service workers to upgrade their skills. I am pleased to announce that the Government has approved my proposals for the introduction of a sponsorship scheme for suitable, experienced health care assistants who wish to become nurses. This new scheme will commence next year and will be administered by the health boards. Successful applicants will be allowed to retain their existing salaries throughout the four years of the degree programme in return for a commitment to work as nurses for their health service employer for a period of five years following registration. Up to forty sponsorships will be available annually. The new scheme will enable suitable applicants to undertake nursing education and training without suffering financial hardship. The greatest advantage of the scheme will be the retention by the public health service of staff who are supported under it, since they will have had practical experience of working in the service and their own personal commitment to upgrading their skills will be informed by that experience. I am confident that the sponsorship scheme will be warmly welcomed by health service unions representing care assistants as providing an exciting new career development path for their members. Education and health are now the two pillars upon which the profession of nursing rests. We must continue to build bridges, even tunnels where needed to strengthen this partnership. We must all understand partnerships donâ?Tt just happen they are designed and must be worked at. The changes outlined here today are powerful incentives for those in healthcare agencies, academic institutions and regulatory bodies to design revolutionary programmes capable of shaping a critical mass of excellent practitioners. You have an opportunity, greater perhaps than has been granted to any other generation in history to make certain those changes are for the good. Ultimately changes that will make the country a healthier and more equitable place to live. The challenge relates to building a seamless preparatory programme which equally respects both education and practise as an indivisible duo whilst ensuring that high tech does not replace the human touch. This is a special day in the history of the development of the Irish nursing profession, and I would like to thank everybody for their contribution. I want to express my particular appreciation of two people who by this stage are well known to all of you – Bernard Carey of my Department and Siobhán O´Halloran of the National Implementation Committee. Bernard and Siobhán have devoted considerable time and energy to the project on my behalf over the past fourteen months or so. That we are here today celebrating the launch of degree level education is due in no small part to their successful execution of the mandate that I gave them. We live in a rapidly changing world, one in which nursing can no longer rely on systems of the past to guide it through the new millennium. In terms of contemporary healthcare, nursing is no longer just a reciprocal kindness but rather a highly complex set of professional behaviours, which require serious educational investment. Pre-registration nurse education will always need development and redesign to ensure our health care system meets the demands of modern society. Nothing is finite. Today more than ever the health system is dependent on the resourcefulness of nursing. I have no doubt that the new educational landscape painted will ensure that nurses of the future will be increasingly innovative, independent and in demand. The unmistakable message from my Department is that nursing really matters. Thank you.

Attachment and temperament in early childhood; implications for later behavior problems.

In the context of a French validation study, the Child Behavior Checklist (CBCL) was administered to more than 3000 French speaking mothers of 5-year-old children. Scores were factor-analyzed. Principal components analysis revealed four dimensions: externalizing and internalizing behavior problems, immaturity and somatoform disorders. Another sample of 40 mothers participated in a longitudinal study, filling in the CBCL when their children were 5 years old. These children had been observed previously in the Strange Situation (SSP) at 21 months. Several dichotomous variables derived from the SSP (e.g. secure versus insecure, proximal versus distal interaction with the mother, avoidant behavior) have been used as predictors of the four dimensions extracted from the CBCL. Hierarchical regressions showed that proximal behaviors with the mother, which reflect temperamental characteristics independently of the quality of attachment, predicted internalizing problems, whereas avoidance of the mother, or insecure-avoidant attachment, predicted internalizing as well as externalizing problems at 5 years of age. These results show that attachment and temperament, as assessed by the SSP, may each have specific implications for later behavior problems.

Ethics masterclass programme

The Department of Children and Youth Affairs (DCYA) recently launched ‘Guidance for developing ethical research projects involving children’. The Guidance considers ethical principles and concepts in research with children and presents a checklist for the design and conduct of research.  In this the third master class of the Children's Research Network for Ireland and Northern Ireland, participants will have an opportunity to respond to the Guidance and to discuss ethical issues in their work. The workshop will also provide participants with the opportunity to discuss the challenges facing the community and voluntary sector in applying and monitoring ethical standards in their work in the absence of formal/institutional ethics committees

Quality assurance in road traffic analyses in Switzerland.

Swiss laboratories performing toxicological road traffic analyses have been authorized for many years by the Swiss Federal Roads Office (FEDRO). In 2003 FEDRO signed a contract with the Swiss Society of Legal Medicine (SSLM) to organize the complete quality management concerning road traffic analyses. For this purpose a multidisciplinary working group was established under the name of "road traffic commission (RTC)". RTC has to organize external quality control, to interpret the results of these controls, to perform audits in the laboratories and to report all results to FEDRO. Furthermore the working group can be mandated for special tasks by FEDRO. As an independent organization the Swiss Center for Quality Control (CSCQ) in Geneva manages the external quality controls in the laboratory over the past years. All tested drugs and psychoactive substances are listed in a federal instruction. The so-called 'zero tolerance substances' (THC, morphine, cocaine, amphetamine, methamphetamine, MDMA and MDEA) and their metabolites have to be tested once a year, all other substances (benzodiazepines, zolpidem, phenobarbital, etc.) periodically. Results over the last years show that all laboratories are generally within the confidence interval of +/-30% of the mean value. In cases of non-conformities measures have to be taken immediately and reported to the working group. External audits are performed triennially but accredited laboratories can combine this audit with the approval of the Swiss Accreditation Service (SAS). During the audits a special checklist filled in by the laboratory director is assessed. Non-conformities have to be corrected. During the process of establishing a new legislation, RTC had an opportunity of advising FEDRO. In collaboration with FEDRO, RTC and hence SSLM can work actively on improving of quality assurance in road traffic toxicological analyses, and has an opportunity to bring its professional requests to the federal authorities.

Validation of the spanish version of the multiple sclerosis international quality of life (musiqol) questionnaire

BACKGROUND: The Multiple Sclerosis International Quality Of Life (MusiQoL) questionnaire, a 31-item, multidimensional, self-administrated questionnaire that is available in 14 languages including Spanish, has been validated using a large international sample. We investigated the validity and reliability of the Spanish version of MusiQoL in Spain. METHODS: Consecutive patients with different types and severities of multiple sclerosis (MS) were recruited from 22 centres across Spain. All patients completed the MusiQoL questionnaire, the 36-Item Short Form (SF-36) health survey, and a symptoms checklist at baseline and 21 days later. External validity, internal consistency, reliability and reproducibility were tested. RESULTS: A total of 224 Spanish patients were evaluated. Dimensions of MusiQoL generally demonstrated a high internal consistency (Cronbach's alpha: 0.70-0.92 for all but two MusiQoL domain scores). External validity testing revealed that the MusiQoL index score correlated significantly with all SF-36 dimension scores (Pearson's correlation: 0.46-0.76), reproducibility was satisfactory (intraclass correlation coefficient: 0.60-0.91), acceptability was high, and the time taken to complete the 31-item questionnaire was reasonable (mean [standard deviation]: 9.8 [11.8] minutes). CONCLUSIONS: The Spanish version of the MusiQoL questionnaire appears to be a valid and reliable instrument for measuring quality of life in patients with MS in Spain and constitutes a useful instrument to measure health-related quality of life in the clinical setting.

Mise en place d'un cathéter veineux central chez l'adulte. 2. Technique détaillée [The central vein catheterization. 2. Procedure, step by step]

La pose d'un cathéter veineux central peut se faire par plusieurs abords. La connaissance de l'anatomie, du matériel, la maîtrise des détails de la procédure pour chaque type d'abord et une attention particulière à l'asepsie sont des prérequis importants pour limiter les risques de complications et pour donner une information complète et exhaustive au patient. Cet article peut être utilisé comme base pour le développement d'une check-list, utile pour les médecins qui doivent procéder à la pose d'un cathéter veineux central mais qui ne possèdent pas encore une maîtrise du geste. Several approaches exist for central vein catheterization. Mastery of the various steps of this procedure and understanding of the basics of asepsis are critical to prevent any complication. They also built the basis for an exhaustive communication with the patient, to obtain an informed consent. This article can in addition be used to develop a checklist in order to (self-)assess competence in procedural skills

Evaluation of email alerts in practice: Part 2. Validation of the information assessment method.

RATIONALE AND OBJECTIVE:. The information assessment method (IAM) permits health professionals to systematically document the relevance, cognitive impact, use and health outcomes of information objects delivered by or retrieved from electronic knowledge resources. The companion review paper (Part 1) critically examined the literature, and proposed a 'Push-Pull-Acquisition-Cognition-Application' evaluation framework, which is operationalized by IAM. The purpose of the present paper (Part 2) is to examine the content validity of the IAM cognitive checklist when linked to email alerts. METHODS: A qualitative component of a mixed methods study was conducted with 46 doctors reading and rating research-based synopses sent on email. The unit of analysis was a doctor's explanation of a rating of one item regarding one synopsis. Interviews with participants provided 253 units that were analysed to assess concordance with item definitions. RESULTS AND CONCLUSION: The content relevance of seven items was supported. For three items, revisions were needed. Interviews suggested one new item. This study has yielded a 2008 version of IAM.